초록접수 현황
| 19F-194 | 구연 발표 |
Usefulness of Mechanical Circulatory Support as a Bridge to Pediatric Heart Transplantation
Sungkyu Cho, Woong-Han Kim, Yu-Jin Kwak, Jae-Hong Lee, Jooncheol Min, Jae Gun Kwak, Jeong Ryul Lee
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Donor shortage is the main problem in pediatric heart transplantation. Mechanical circulatory support(MCS) is known to increase waiting list survival. However, in terms of complications and usability, there are few reports of MCS before heart transplantation
Methods : Our retrospective study included 22 patients younger than 18 year of who underwent heart transplantation in our institution between August 2005 and July 2019. Preoperative diagnosis was either cardiomyopathy (n=15, 68.1%) or congenital heart disease (n=7, 31.8%). MCS was performed in patients classified as Interagency Registry for Mechanically assisted circulatory Support(INTERMACS) 1 and 2. Clinical outcomes were evaluated and compared between the patients (Group A, n=11) who were supported with MCS and those(Group B, n=11) who were not supported. INTERMACS profile was more severe in Group A than Group B(p<0.001)
Results : Mean follow up period was 45.3±33.4 months. There was a early death due to refractory thrombocytopenia, and 5 late death due to rejection after 18, 48 months(n=2), unknown sudden death after 49, 59, 75 months(n=3). Overall survival rates at 1, 5 and 8 years were, 95.5%, 62.8%, and 50.2% respectively, with no significant difference between the two groups(p=0.774). Rejection-free rates at 1 and 5 years were respectively 38.4% and 25.6%, with no significant difference between the two groups(p=0.927). There were no significant differences in morbidity including Acute kidney injury(p=0.087), and reoperation for bleeding(0.138) between two groups
Conclusion : MCS support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. And, it has increased waiting list survival.
Methods : Our retrospective study included 22 patients younger than 18 year of who underwent heart transplantation in our institution between August 2005 and July 2019. Preoperative diagnosis was either cardiomyopathy (n=15, 68.1%) or congenital heart disease (n=7, 31.8%). MCS was performed in patients classified as Interagency Registry for Mechanically assisted circulatory Support(INTERMACS) 1 and 2. Clinical outcomes were evaluated and compared between the patients (Group A, n=11) who were supported with MCS and those(Group B, n=11) who were not supported. INTERMACS profile was more severe in Group A than Group B(p<0.001)
Results : Mean follow up period was 45.3±33.4 months. There was a early death due to refractory thrombocytopenia, and 5 late death due to rejection after 18, 48 months(n=2), unknown sudden death after 49, 59, 75 months(n=3). Overall survival rates at 1, 5 and 8 years were, 95.5%, 62.8%, and 50.2% respectively, with no significant difference between the two groups(p=0.774). Rejection-free rates at 1 and 5 years were respectively 38.4% and 25.6%, with no significant difference between the two groups(p=0.927). There were no significant differences in morbidity including Acute kidney injury(p=0.087), and reoperation for bleeding(0.138) between two groups
Conclusion : MCS support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. And, it has increased waiting list survival.
첨부파일 : abstract.pptx
책임저자: Woong-Han Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Sungkyu Cho, E-mail : csk1022@hanmail.net